When it comes to your balls (or to the nuts of someone about whom you care), don’t mess around. Get intensely ornery and proactive until a doctor takes your concerns seriously enough to order some tests. I’m going to let you know what you might be facing if you decide to let your doctors brush you off.
My doctors had been dismissive of my concerns for well over ten years, where the following excerpt from a physician’s report is typical of the way in which they would pat me on the head and send me home:
The only concern he actually has [about his health] is in regards to a lump that he has on his testicle. Was told by [Dr. X] a few years ago it was not something he really needed to worry about and his concern is the possibility of it being testicular cancer. We discussed the fact that at his age, he is actually too old to have testicular cancer and that it was highly unlikely that is what he would have.
They kept telling me that it must be a hydrocele or varicocele and that I should just calm down and ignore the slowly growing mass. Whenever I requested at least some sort of testing, I was told that it would be a waste of resources that could be better spent on people who had “real” problems.
One day, however, it turned out that they had been wrong all along.
Well, that’s not the whole truth: they had been both wrong and negligently cavalier about playing the odds when they had nothing personal to lose; in fact, because of the litigation involved, this is the only chapter in which I’ll be changing some names.
* * *
Monday, October 21st, 2013, started with a very typical ring (where I’m a five o’clock riser). [Redacted] dropped the kids off at school on the way to [] classrooms, and I was reviewing some student records while planning therapy sessions. The difference began when I couldn’t find a sitting position that wasn’t bothering my lower left abdomen.
Nearly three years earlier (January, 2011) I had gone in to have a similar pain checked out on my right side, thinking that it might be appendicitis, but an exam and CT scan (only to the base of my abdomen) revealed nothing unusual. The physicians explicitly ruled out any referred pain from the testicular mass without a scan of the scrotum, so I got used to just putting up with occasional mysterious twinges on the right. I mean, what do you do when something is going wrong but your doctors can’t do anything more than shrug?
That morning, however, the pain was getting worse. I tried reading while reclining, left, right, and back. Then I tried to sit up and an actual noise came out of my mouth. I know that if I’m at the noise-making level, then something is really not right. Standing offered no relief. I tried lying flat on my stomach, but again it kept intensifying. I strongly hoped that it was just something going around a corner, where maybe I had absentmindedly swallowed a bucketful of toy soldiers. I texted [redacted] to say that I would likely need some help, who immediately headed for home because I had never sent her such a message before. I don’t tend to cry “wolf” even when one is gnawing on my femur.
I was starting to feel sort of shocky (sweaty, clammy, tingling extremities, vision darkening around the edges) and I made it to the bathroom so I could lighten the load in prep for flight. Then the pain-induced vomiting began, which quickly spiraled because the retching caused me to double over more tightly and create even more pain by compressing the abdomen. Eventually those waves passed, and I managed to stretch out.
I was taken on an exciting twenty-minute drive to Urgent Care. (I hadn’t realized until then just how bumpy the freeway was.) They tucked me into an ambulance headed for Emergency, where they subjected me to an ultrasound that involved repeatedly crushing my testicles and inducing more intense abdominal pain. Next I had a CT scan that showed a massive retroperitoneal lymph node on one side, and a not-as-giant one (but still orange sized) on the other. They were pushing other organs out of their way and wrapping around such inconsequential structures as my blood supply.
I left the hospital a week later, absent one testicle but having gained a PICC line. Nine weeks’ worth of chemo followed (which was all the more unpleasant for having to deal with the BII phobia), and that ultimately halved the size of the nodes and left behind only scar tissue (i.e., no active cancer remained). As of this writing it has been six more weeks and I am still waiting for some of the side effects to get better. That’s evidently going to be a very slow process, and I am not feeling very patient about waiting. I originally wanted the healing process to be behind me before publishing this book, but I have changed my mind as I have no idea how long that might take. (As of this scouring of the fourth edition, I have been cancer free for over five years.)
The upshot is that a simple test anywhere during the previous ten years would have avoided the involvement of the lymph nodes (as the mass would have been removed), but until I was vomiting from the pain, no doctor felt the need to take my concerns seriously. So here is my “I’m not a doctor” opinion: if you have a testicular mass, no matter how slowly it grows, no matter how old you are, insist on being tested... unless of course you like chemotherapy.
And it won’t be disguised in any cutesie-pie way where you can figure out the person’s real name. If you fiddle around with any name I give here, and it seems to equate with the name of any person (living, dead, or otherwise), then you have identified the wrong person. And no, that is not a clue either; it is not a veiled reference to some sort of “Dr. Wrong,” “Dr. Wright,” or anyone else. Just leave it alone.